<%-- 
    Document   : register
    Created on : Nov 28, 2011, 4:21:05 PM
    Author     : Admin
--%>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
<style type="text/css">
<!--
body {
	background-image: url();
	background-repeat: no-repeat;
}
body,td,th {
	font-size: medium;
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<body>
<p>
<font size="3" face="verdana" color="purple">
Pendaftaran Travel Online
</font>
</p>
<table width="427" border="0">
  <tr>
    <td width="137">Nama trevel</td>
    <td width="280"><input type="text" name="confirm" id="fullname" /></td>
  </tr>
  <tr>
    <td>Alamat</td>
    <td><input type="text" name="FullName" id="address" /></td>
  </tr>
  <tr>
    <td>Kota / Kode Pos</td>
    <td><form id="form1" name="form1" method="post" action="">
      <label>
        <select name="city" id="city">
          <option>--Pilih Kota--</option>
        </select>
      </label>
      <label>
        <input type="text" name="postcode" id="postcode" />
      </label>
    </form></td>
  </tr>
  <tr>
    <td>Telepon</td>
    <td><input type="text" name="password" id="phone" /></td>
  </tr>
  <tr>
    <td>Email</td>
    <td><input type="text" name="Email" id="Email" /></td>
  </tr>
  <tr>
    <td>Password</td>
    <td><form id="form2" name="form2" method="post" action="">
      <label>
        <input type="text" name="password2" id="password" />
      </label>
    </form></td>
  </tr>
  <tr>
    <td>Confirm Password</td>
    <td><form id="form3" name="form3" method="post" action="">
      <label>
        <input type="text" name="confirm2" id="confirm" />
      </label>
    </form></td>
  </tr>
</table>

  <label>
    <input type="checkbox" name="setuju" id="setuju" />
setuju</label>
<p>
  <input type="submit" name="SignUp" id="SignUp" value="Sign Up" />
</p>
<p>&nbsp;</p>
</body>
</html>
